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- diabetes mellitus A heterogeneous disease due to a disorder of glucose metabolism leading to hyperglycaemia which in severe cases can lead to coma and death if not controlled. It probably arises due to an interaction of both enviromental and genetic factors. Formerly classified into either insulin- dependent (IDDM) or non-insulin dependent (NIDDM) kinds, it has more recently been divided into type I and type II. Type I is classically young onset and associated with diminished production of insulin. There is an association between type I diabetes and the expression of certain HLA antigens (see MAJOR HISTOCOMPATIBILITY COMPLEX) particularly B8, B15, DR3, and DR4. Type I diabetes mellitus is an autoimmune disease in which the insulin- producing b-cells of the pancreas are selectively attacked and destroyed. Type II is often late onset, there is appreciable insulin secretory capacity but it may be decreased or delayed and there is a varying degree of insulin resistance especially when obesity is a feature. There is a strong family aggregation. See also: INSULIN AND ITS RECEPTOR.
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